Kitzhaber Eyes Long-Term Care Waivers

Obama’s support for Wyden bill means earlier waivers in states like Oregon
March 3, 2011 -- Oregon’s first waiver request under the 2010 national health reform law could be to integrate long-term care, according to Gov. John Kitzhaber, who was at the White House when President Obama said he supported giving more flexibility to states that could do healthcare better.
“We’ll require some significant waivers -- some as soon as June -- to merge and integrate long-term care services with other services,” Kitzhaber told Oregon Public Broadcasting. “I was at the White House when the President made that announcement and we feel it’s very, very good news for Oregon.”
Obama endorsed a bill this week by Oregon Sen. Ron Wyden that would allow states to pursue federal waivers earlier than expected.
The bill, co-sponsored with Republican Sen. Scott Brown of Massachusetts, moves up the start date that states can ask for waivers from 2017 to 2014. States could essentially opt-out of certain provisions of the 2010 law as long as they provide equal or better coverage to at least the same number of people with costs the same or better.
“I think that’s a reasonable proposal.  I support it,” Obama told governors at the White House, quoted in the Oregonian. “It will give you flexibility more quickly, while still guaranteeing the American people reform. If your state can create a plan that covers as many people as affordably and comprehensively as the Affordable Care Act – without increasing the deficit – you can implement that plan. And we’ll work with you to do it.”
Beyond long-term care, there are a number of other ideas in Oregon that could turn into federal waivers.
It was federal waivers for Medicare pilot projects that lay at the crux of Kitzhaber’s efforts in 2009 2007 when he led the non-profit Archimedes Movement. At the time, he envisioned demonstration projects to prove Oregon could spend Medicare money more wisely.
But the Oregon AARP lobbied against it, and the idea failed to make it into SB 329, the precursor to HB 2009. Last week, Jerry Cohen, the group’s executive director, cautioned against some of the ways Oregon might integrate long-term care.
“We cannot afford to dismantle a system that is highly effective to help a dysfunctional system,” Cohen wrote in an opinion piece last week at The Lund Report. “State policymakers should not have a false sense of security that they can sign a contract with a managed care company, pass on the responsibility and keep a lid on costs.”
Another possible federal waiver might open the health insurance exchange to all Oregonians, rather than excluding large employers, it will now. This idea was part of Wyden’s health reform plan in 2009 when Obama called it too “radical” for the country.
Obama also called Wyden a “real thought leader,” something he’s clearly demonstrated this week.


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Time to show that Oregon can adopt a single payer plan - HB 3510 and SB 888 have been introduced. Time for the Governor to get behind the effort.